BRIAN COWEN has rejected a Fine Gael suggestion that the HSE be dismantled and has accused the Opposition of failing to accept the need for reform.

During sharp exchanges in the Dáil yesterday about the HSE audit of the controversial Skill training programme, Fine Gael leader Enda Kenny accused the Government of turning a blind eye to waste in the health service.

He also criticised the Government for repeated health service financial scandals.

“Five years ago, you told us the famous PPARS debacle would be the last, and that there would be accountability and transparency,” Mr Kenny told the Taoiseach.

He said it had become “a case of see no waste, hear no waste, speak no waste, whether it is Fás, the HSE, departments or banks”.

Mr Cowen had turned a blind eye to the back-office bureaucracy, with the number of grade eight managers jumping from six to more than 700, he said. “You have turned a blind eye to the advice of former HSE chief executive Brendan Drumm that HSE bureaucracy should be cut by 30 per cent.

“You have turned a blind eye to the €100 million spent on consultants’ reports that are lying on shelves with nothing being done about them. A blind eye was turned to the €121 million that the HSE spent on taxis over four years.”

The Fine Gael leader then asked the Taoiseach, “given the appalling scandal and the litany of waste that runs through Fás, banks, departments and now the HSE, where nobody is accountable, do you agree it’s time to dismantle the HSE in its current form?”

But rejecting the claims, the Taoiseach accused Mr Kenny of wanting to dismantle structures without providing an alternative. He insisted the centralisation of health services, particularly hospitals, was a far better approach than the regional system would ever be capable of providing.

There had been improvements in health service provision and there were many people whose experiences of the health service had been favourable, he said.

Questions were raised in the Dáil following revelations of a HSE audit of the Skill training programme, which found fundamental elements of internal control were not in place and that there were serious shortcomings in relation to areas such as governance, funding and foreign travel arrangements.

Mr Kenny said it was “absolutely ironic” that the Minister for Health actually congratulated the HSE for finding the rotten apple in the box yet again.

“This is a scandalous situation. There is no accountability, no transparency and nobody being brought to book here.”

The Taoiseach said, however, the Minister was “simply pointing out that an internal audit by the HSE had uncovered this situation, which has been referred to the Garda. That is an exercise in accountability.” The State financial watchdog, the Comptroller and Auditor General, was also dealing with the matter and the public accounts committee would consider it today.

He said the Opposition consistently argued for the status quo rather than accepting the need for reform. “Every reform we propose is fought tooth and nail because various interests have a view.”

Mr Cowen said that rather than portraying the situation as incapable of reform or seeking to hold up change, many people in the service were seeking to introduce change on the basis of the agreement negotiated by the Government in the Croke Park agreement.

The Taoiseach referred to the €1 billion in cuts in the health service last year, which included €650 million in cuts in labour costs and €350 million through “efficiencies”.

Further cuts would be necessary and the Croke Park agreement could minimise any impact on frontline services by ensuring that all changes in work practices were agreed, the Taoiseach said.